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Underweight prevalence in six southern African countries, where drought and HIV/AIDS have combined to the detriment of children’s nutritional status.

One out of five children in Malawi, Mozambique and Zambia is underweight, and the proportion of underweight children in Lesotho and Zimbabwe was higher in 2004 than in 1990. Swaziland has a child underweight prevalence rate of 10 per cent and the highest rate of adult HIV prevalence in the world.

Eastern/Southern Africa

The Eastern/Southern Africa region has shown no improvement since 1990 in reducing the proportion of underweight children. The absolute number of underweight children has actually increased due mainly to declines in agricultural productivity, recurring food crises associated with drought and conflict, and increasing levels of poverty. At the same time, HIV/AIDS has posed serious challenges to nutrition development.

In regional terms, the main positive indicator is the increased rate of exclusive breastfeeding in the first six months of life, which now stands at 41 per cent, a higher rate than in any other region except East Asia/Pacific.

Of the 17 countries with sufficient trend data to assess progress towards the MDG target, only Botswana is on track. Botswana has reduced underweight prevalence from 17 per cent in 1996 to 13 per cent in 2000, a remarkable achievement given its number two place (after Swaziland) in terms of adult HIV prevalence.26

There are insufficient data to estimate whether Swaziland will achieve the MDG target, but it has a lower proportion of underweight children (10 per cent) than any other country in the region and has reduced the proportion of under-fives suffering from wasting to just 1 per cent. Given the synergies between undernutrition and HIV in children, however, these results need to be interpreted with caution.

At 12 per cent, South Africa has a lower proportion of underweight children than any other nation except Swaziland. However, South Africa has been going backwards, and its proportion of underweight children has risen yearly since 1994–1995. The country also has by far the region’s lowest prevalence of exclusive breastfeeding.

In Ethiopia, almost half of children are underweight, a rate unchanged since 1990, making it unlikely the country will achieve the target without an extraordinary push. Only 28 per cent of households benefit from iodized salt, the lowest coverage regionally.

Underweight in Burundi and Madagascar exceeds 40 per cent of under-fives, with no sign of improvement. Rates of stunting are highest in Burundi (57 per cent) and of wasting in Somalia (17 per cent).